PKV new business is booming At the expense of the GKV

PKV new business is booming - to the detriment of the statutory health insurance

20/11/2011

While some public health insurance funds are suffering massively from the burdens of the past health care reform, private health insurers (PKV) benefit from the new freedom of choice and were able to increase their new business by 20 percent in the first half of 2011, reports „Handelsblatt“.

Since the beginning of the year, the change for well-earning insured persons in the direction of private health insurance has been made much easier. If they had to prove a correspondingly high income for at least three years, then since this year the one-time income limit of 45,900 euro annual income has been exceeded. This option has evidently been used by many insured persons in the first half of 2011 and has been transferred to private health insurance. Many promise not only lower contribution costs but also significantly improved benefits. But even in private health insurance today, all services are no longer taken over without inquiries, reports the PKV Ombudsman, Dr. med. Klaus Theo Schröder, opposite the „Doctors newspaper“.

PKV new business grows by 20 percent
The private health insurance association was also pleased with the significant increase in new contracts and emphasized the positive effect of the political decisions. But where private health insurance benefits, statutory insurance companies are struggling with growing difficulties. The increase in new business of private health insurance in the first half of 2011 by around 20 percent is clearly at the expense of the statutory health insurers. Above all, well-earning employees increasingly move in the direction of the private, which significantly weakens the membership structure in the statutory health insurance. Exaggerated shown the old, sick insured, whose contributions bring less income than their supply costs, remain in the statutory health insurance (SHI) while the young, healthy, well-earning members switch to private health insurance. So that we more or less undermine the solidarity principle underlying the statutory health insurance system. While private providers are the „Handelsblatt“ according to the „noticeable revival of competition“ and the new addition of 54,000 fully insured in the first half of 2011, some health insurance companies are struggling with considerable financial difficulties and the first had to cease operations (see City BKK and BKK for health professionals).

Good deals with supplementary insurance
Today, around 8.95 million Germans are fully insured in private health insurance. By contrast, the overwhelming majority of some 70 million people are members of a statutory health insurance scheme. However, the GKV loses approximately the same number of members as the PKV wins. In addition, the statutory health insurance companies have been prohibited by the legislature from continuing to cooperate in the business with the supplementary insurance, so that this business area falls exclusively to the more than 40 private health insurers. In the first half of 2011 private health insurance companies were able to conclude a net additional 119,000 supplementary insurances, which was also significantly higher than in the previous year (77,000), reports „Handelsblatt“. Overall, according to the latest reports, private insurers currently provide more than 22 million supplementary insurances. The business with private health insurers is therefore running quite well. For the full year, the industry expects premium income of 34.9 billion euros, which is an increase of 4.9 percent. The overwhelming majority of the revenue accounted for 32.76 billion euros on health insurance, but also in the field of long-term care insurance, private insurers recorded 2.14 billion euros in premium income.

Rising expenses for health care benefits also in private health insurance
However, private health insurances are also seeing stronger growth in annual insurance spending, amounting to around € 23.1 billion in the first half of 2011. This corresponds to a rise of 5.5 percent over the same period last year „the increase in costs in 2011 was well above the general price increase“ remains, cites that „Handelsblatt“ from the figures report 2010/2011 of the PKV-Verbandes. Critics suspect that this is also one of the reasons for the fact that today's services are looked at much more closely than a few years ago. This assessment contradicts Klaus Theo Schröder, former State Secretary in the Federal Ministry of Health and since January 2011 PKV Ombudsman, and told the „Doctors newspaper“, that the refusal to pay for special services could also reflect a higher level of private health insurers' attention to the quality of services provided.

Increased quality standards or cost pressure?
Accordingly, a refusal to reimburse costs would not necessarily reflect increasing cost pressure, but may be an indication of the increasing quality demands of private insurers. Like Dr. Schröder explained, will too „in the PKV increasingly discussed what a good quality care“, and in principle it is „an advance when quality aspects play a bigger role.“ According to the PKV Ombudsman, 18 percent of the disputes that are to be settled about him concern the need for medical services. Before a plannable expensive treatment private insured should therefore urgently submit a cost estimate and ask their insurance company, which share of the costs is taken. As an example of denials of the cost assumption called Dr. Schroeder different lifestyle products whose costs were previously often worn without further demand, which are not taken over by many private health insurance today. (Fp)

Read about:
PKV: 20 percent more full insurance
Lower PKV commissions planned
Change to PKV often not advisable
Warning against PKV low rates
PKV: 150,000 insured in the debt trap
Numerous private health insurance plans to increase contributions for 2011
Contributions of private health insurance are increasing